This research uses a case study of Ghana to develop a framework to address the question: how should ministries of health in developing countries approach tailoring supply chain segmenta-tion and support strategies for public health products in their countries in order to improve supply chain performance? In the resulting framework three supply chain types with corre-sponding baseline support strategies are identified. Furthermore, a systematic approach to analyzing country complexity is developed in order to tailor the baseline supply chain seg-mentation and support strategies for particular countries. We apply this framework in Ghana and identify four unique environments that are distinguished by regional and facility differ-ences. We then present tailored supply chain support strategies that address the specific con-straints of each environment and recommend high priority interventions to improve public health impact. This framework and the thinking behind it extend existing theory about supply chain segmentation and supporting operational strategies currently being used for commercial supply chains in the developed world by adapting it for application to public health supply chains in the developing world.